The present invention relates to a method for cleaning tooth root surfaces and surrounding gingival tissue by means of a preparation which is applied on the root surface and in the periodontal pocket formed in the gingival tissue.
The tooth root is that part of the tooth which does not belong to the crown and which is normally enclosed within the gingival tissue and the jaw bone. Loss of teeth due to periodontal disease is together with caries one of our most frequent dental diseases, caused by a bacterial inflammatory activity starting from a plaque layer formed on the tooth surface and in the periodontal pocket.
If left unchecked the periodontal disease is gradually degenerating the bone support of the tooth and eventually causes loss of the tooth. In that case the process has been going on so long that most of the supporting structure surrounding the tooth has been lost. If the surrounding gingival tissue is not attached to the tooth, it does not contribute to the support of the tooth but merely makes the cleaning of the tooth more difficult and thereby increases dental calculus formation. The presence of dental calculus and the fact that the tooth root surface is not protected by any dental enamel may cause a bacterial activity and a further erosion of the jawbone.
The normal treatment method for gingivitis, ie inflammatory condition of the gingival tissue, and periodontal disease, is removal of plaque layers and calculus formations on the tooth root surfaces. Such a therapy must be followed by a very careful hygiene, specifically with respect to the tooth root surface at the gingival margin area in order to prevent any further inflammations. In case of very deep periodontal pockets, and when normal depuration and hygien has not been succesful, surgical periodontal therapy might be used, ie the gingival tissue is opened and calculus material, inflammatory tissue and degenerated jaw bone material is removed. Some times antibiotics and anti-bacterial pharmaceuticals can be used, specifically after a surgical operation during the healing period of the gingival tissue, for instance by means of a local antibiotical therapy with Elyzol in the periodontal pocket.
In some cases it is possible to reshape bone tissue to some extent. By modern bone-reshaping methods bone growth may be stimulated close to the tooth root, for instance by means of Emdogain or by means of specific filters or membranes (GTR).
For all these treatment methods a careful cleaning of the tooth root surface and the periodontal pocket is a critical factor. The cleaning can be done in connection with normal plaque and dental calculus removal (depuration) or in connection with surgical periodontal operations. The preparations that have been used so far in connection with cleaning of tooth root surfaces and periodontal pockets are usually not effective enough or they are too aggressive to healthy tissue. Cleaning liquids are difficult to apply on the infected tooth root surface, the liquid dissipates into periodontal pockets in the surrounding gingival tissue and there is a lot of waste and the cleaning procedure is often time-consuming. The cleaning liquid is not efficient enough when cleaning deep into the pockets is required. On the other hand liquids including more aggressive and efficient active components can not be used due to the risk of irritating the surrounding gum tissue.
To combine these methods with antibiotics is not to recommend, because of the systemic effect of the antibiotics and also because of the necessary repeatment of such an antibiotical treatment. Furthermore, doubtful long run results together with a certain resistence do not speek for antibiotic treatment methods.